| NPI | 1902344906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 077500-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9395160) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2021-08-27 |